From the Nuclear Medicine Department, University General Hospital, Ciudad Real.
Mathematical Oncology Laboratory (MôLAB), Castilla La Mancha University, Ciudad Real.
Clin Nucl Med. 2019 Oct;44(10):e548-e558. doi: 10.1097/RLU.0000000000002715.
To study the association of metabolic features of F-fluorocholine in gliomas with histopathological and molecular parameters, progression-free survival (PFS) and overall survival (OS).
Prospective multicenter and nonrandomized study (Functional and Metabolic Glioma Analysis). Patients underwent a basal F-fluorocholine PET/CT and were included after histological confirmation of glioma. Histological and molecular profile was assessed: grade, Ki-67, isocitrate dehydrogenase status and 1p/19q codeletion. Patients underwent standard treatment after surgery or biopsy, depending on their clinical situation. Overall survival and PFS were obtained after follow-up. After tumor segmentation of PET images, SUV and volume-based variables, sphericity, surface, coefficient of variation, and multilesionality were obtained. Relations of metabolic variables with histological, molecular profile and prognosis were evaluated using Pearson χ and t test. Receiver operator caracteristic curves were used to obtain the cutoff of PET variables. Survival analysis was performed using Kaplan-Meier and Cox regression analysis.
Forty-five patients were assessed; 38 were diagnosed as having high-grade gliomas. Significant differences of SUV-based variables with isocitrate dehydrogenase status, tumor grade, and Ki-67 were found. Tumor grade, Ki-67, SUVmax, and SUVmean were related to progression. Kaplan-Meier analysis revealed significant associations of SUVmax, SUVmean, and multilesionaly with OS and PFS. SUVmean, sphericity, and multilesionality were independent predictors of OS and PFS in Cox regression analysis.
Metabolic information obtained from F-fluorocholine PET of patients with glioma may be useful in the prediction of tumor biology and patient prognosis.
研究氟代胆碱代谢特征与胶质瘤组织病理学和分子参数、无进展生存期（PFS）和总生存期（OS）的相关性。
前瞻性多中心非随机研究（功能和代谢性神经胶质瘤分析）。患者接受基础氟代胆碱 PET/CT 检查，并在组织学确认胶质瘤后纳入研究。评估组织学和分子特征：分级、Ki-67、异柠檬酸脱氢酶状态和 1p/19q 联合缺失。根据患者的临床情况，在手术后或活检后进行标准治疗。通过随访获得总生存期和无进展生存期。对 PET 图像进行肿瘤分割后，获取 SUV 和基于体积的变量、球形度、表面积、变异系数和多发性。使用 Pearson χ 和 t 检验评估代谢变量与组织学、分子特征和预后的关系。使用接收器工作特征曲线获得 PET 变量的截止值。使用 Kaplan-Meier 和 Cox 回归分析进行生存分析。
共评估了 45 例患者，其中 38 例被诊断为高级别胶质瘤。发现 SUV 基于变量与异柠檬酸脱氢酶状态、肿瘤分级和 Ki-67 存在显著差异。肿瘤分级、Ki-67、SUVmax 和 SUVmean 与进展有关。Kaplan-Meier 分析显示，SUVmax、SUVmean 和多发性与 OS 和 PFS 存在显著相关性。SUVmean、球形度和多发性是 Cox 回归分析中 OS 和 PFS 的独立预测因素。
从氟代胆碱 PET 获得的胶质瘤患者的代谢信息可能有助于预测肿瘤生物学和患者预后。
